Q: Like clockwork, my twelve-year-old son gets sick during the winter. He usually comes down with a fever and sore throat and then develops a terrible cough. Because he misses a lot of school, he gets very stressed about catching up. I wonder if you have any prevention advice for us this year.
A: The best way for children to avoid getting sick is frequent handwashing and avoiding touching their face. Practicing cough hygiene, avoiding exposure to tobacco and other smoke and using hand sanitizer can also help. Don't forget that getting regular moderate exercise and plenty of sleep, eating colorful fruits and vegetables and minimizing stress can boost or maintain healthy immune systems.
Obtaining immunizations is another important method in preventing viral infections. Updating immunizations against influenza and COVID-19 not only helps to prevent severe illness and hospitalization caused by these bugs but also protects against milder infections that can mimic the common cold.
The use of probiotics is an area of interest for further research. Several studies suggest probiotics probably decrease the risk of developing upper respiratory tract infections, the duration of illness and the need for antibiotics to treat respiratory tract infections in children with regular use for three to six months, while adverse effects were minor. Of course, prior to starting any treatment course, I recommend that you discuss your child's specific circumstances with your doctor.
Q: Is caffeine harmful for children? I have read differing opinions. My son likes to drink black tea with milk in the morning with me, but I'm worried about the caffeine habit.
A: There's not enough research to determine a specific amount that is safe for children to consume. As caffeine has no nutritional value and could cause effects that negatively impact health and development, the safest amount of caffeine for children is none.
Possible adverse effects that children may experience after consuming caffeine include trouble sleeping (which could lead to trouble concentrating at school), anxiety, palpitations, upset stomach and diarrhea. Adverse effects of long-term use could include withdrawal headaches and agitation if children stop consuming caffeine.
The American Academy of Pediatrics advises against caffeine for children 11 or younger and to limit caffeine to at most 100 mg daily for teens. They also advise against any use of energy drinks for all children and teens. Examples of 100 mg or less of caffeine include:eight ounces of coffee, eight ounces of black or green tea, 12 oz of soda.
Parents can help children decrease their caffeine consumption by modeling good behavior and choosing non-caffeinated foods and drinks when eating together, offering water, milk, herbal tea (such as mint, ginger or fruit) or flavored seltzer for drinks and gradually weaning children off caffeine consumption by 25% each week until they are completely off or at least no longer experiencing adverse effects.
Q: My daughter is three and is having a lot of trouble transitioning to bedtime. I read to her before turning off the light, but when I do leave, she pops up and begs me to stay. This is heartbreaking since she cries and screams every time. What should I do?
A: Some degree of bedtime resistance is common in young children and is often temporary (lasting less than three months). The mainstay of treatment is behavioral intervention, which aims to change a child's behavior through adjustments in parenting.
In this case, I would add another one or two soothing activities to the bedtime routine. Following reading, a parent could dim the lights, help the child find a transitional object (like a stuffie) and sit with the child for quiet time. Having a parent stay in the room for a little bit when the lights are dim may also help them transition to darkness. Then, when the child is drowsy but still awake, the parent can slip away quietly. Maintaining a routine would then be the next step to train a child's circadian rhythm and enable faster sleep onset.
If bedtime resistance behaviors persist or are causing significant impairment of function for the child, parent or family, I recommend seeking help from a medical provider and/or pediatric behavioral or sleep specialist.
